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Affidavit for Import of Materials into Trout Valley Ranch <br />Date or Time Period of Import: <br />Description of Import Material: <br />Entity Providing Material to Mine (not the trucking Company): <br />I hereby certify that the material described above and brought to the Fairplay Au Pit is inert, which <br />means it is free from any chemicals, toxic substances, acid forming material, or any other material <br />which would violate the material waste disposal laws of the State of Colorado. <br />Signature <br />Signer's Position in Company <br />Date: <br />Written Name of Signer <br />Company <br />Fairplay Au Pit March 2017 D-9 ans LcwkU d Auodam P X <br />